The saga continues, and it hasn't gotten any EZer.

Since my last post, I have had surgery and a variety of scans (PET with contrast dye, echo-scan of neck soft tissue, PSMA with contrast) and surgery. The surgery was to remove the lesion that proved to be melanoma in my R. ear lobe. The PET scan and echo-scans were prepertory to that. With part of the ear lobe, the surgeon also took three lymph nodes from my neck on the R side for biopsy. After surgery and post-surgery pathology, they reported 'clear margins' on the ear lobe and negative for melanoma in the lymph nodes. That was done by Dr. Shellenberger at MD Anderson/Banner in late November of 2022. It is now March 8, 2023, and lesions (multiple) have appeared on my R ear lobe. They itch, and like the earlier granuloma, have a tendency to form blood blisters, pop untouched, and bleed profusely. I spoke to the triage nurse and MD Anderson and sent her iPhone photos of the ear lobe. She consulted with Dr. Shellenberger. He said I should see my dermatologist. So I did. I saw Ms. Mack on March 6, 2023. She consulted with another provider, then told me that it did not appear to be cancerous but they were unsure of what it might be. She prescribed Halcinonide cream (topical) and both an antiviral (Valacyclovir) and an antibiotic (Doxycycline), all three to be used for a 10-day course and then reexamine.

The earlier-mentioned PSMA scan was a result of my PSA test showing a positive result on the routine annual re-check on December 13, 2022. The results were low, only 0.03, but it has been non-detect for seven years, and should have stayed that way. I was referred to a different clinic at MD Anderson where I say provider Michael Snyder. He repeated the PSA with the same results then ordered the PSMA scan. The results of the scan were inconclusive -- no sign or active prostate cancer was found, but two spots that might be of concern for other malignancies were noted, and I've been scheduled to repeat the PSMA in April. I have to be sedated for the PET scan and/or the PSMA. They aren't as bad as an MRI for my claustrophobia, but more than I can do without some sedation.

Meanwhile, On February, 24, I fell on the sidewalk and broke a rib rib. Was seen at Dignity Health ER, Ellsworth/Elliot. CT and blood work. Clean break, rib #7 (4th rib, R side), 6mm displacement. Prescribed pain killers (hydrocodone/Tylenol and Ibuprofen) x 5 days. Dr. says will heal, but will hurt. 1-3 months normal for healing. Also on CT, report of gallstones, 'tiny' hiatal hernia, and atrophied pancreas. I discussed those findings with Dr. Klein, my PCP, and he was not concerned. At 11 days after the break, the rib still is excruciatingly painful under the 'wrong' circumstances, such as a sneeze.

My friend in Texas, who has the melanoma first found due to the pylogenic granuloma is having a very hard time. Her melanoma spread from a single spot on her leg to an outbreak of cancerous lesions 10 inches in diameter in a matter of weeks. She is being treated by radiation and chemotherapy, and is unable to walk or stand at this time, so can't work. And she's a single mother. Her melanoma was first diagnosed on October 28, 2022, the same day I was first diagnosed with the melanoma on my ear lobe.

Empathy is not always EZ.

I participate in a Facebook-based support group for prostate cancer sufferers, patients, survivors, and their supporting family, friends, and lovers. There have been many discussions of the symptoms and impact on the body of the cancer and the effectiveness and side effects of the various treatments. Side effects that often include urinary incontinence and erectile dysfunction (ED) formerly known as impotence. Everyone's journey through this often fatal landscape is wildly unique and different. Today one of the partners of a cancer sufferer posted a note that ED just didn't matter and implied that forum members should just be glad to be still alive and shut up about that issue. A couple of men (both suffering extreme cancer-related life-threatening problems) posted that, in their dire situation, sex simply no longer mattered to them. The original poster (OP in today's language) then congratulated those two for "being comfortable in your own skin and for having good self esteem and for knowing what a REAL MAN is." I found her words to be insensitive and hurtful, and did not immediately have the words to respond. 

A couple of other cancer-suffering men did chime in and post to the effect that she simply did not understand. One man went so far as to call her patronizing. I'm not sure I'd have used that word. Anyway, after some time pondering, below is what I posted in reply to her REAL MAN comment:

Thank you, Robert and Henry. I wanted to respond to Patsy but needed some time to think so that I could, hopefully, respond in a way that does neither diminish those with greater problems and suffering nor hurt Patsy for her lack of understanding and empathy while making it plain that her words were hurtful.

My dear wife and I have remained committed and faithful for over 48 years. We have raised a great family who are doing well and enjoying life. I am thankful for her and our children and grandchildren, for my life, remaining health, and capabilities, and I have great sadness for those, like [name withheld here] and many others, whose situation is really much more dire and difficult. My PC was originally diagnosed as stage 2 with a Gleason of 4+3 with “excursions to 5.” Twelve of fourteen biopsy cores were positive for cancer although my PSA had never been over 4 and all of my DREs had been unremarkable. The biopsy was recommended because my PSA went from 2 to 4 in a three-month period (followed because I did have BPH, and the PSA increase was verified with a follow up and a second lab). The RP surgery proved the cancer had spread outside the prostate capsule so my diagnosis was changed to stage 3. I have, and continue, to receive what, to the best of my ability to judge, is excellent medical care and I have excellent insurance. My oncologist, supported by post-surgery pathology, believes that all the cancer was removed. At six-months post-surgery, my PSA is ND. I do recognize that in many, many ways, I’ve been exceedingly blessed.

I have no idea how to communicate the loss that my wife and I both feel, other than to say that it hurts. Our hurt in no way diminishes anyone else’s pain. But it is real. We have benefited from joint counselling post-surgery. Depression meds (for both of us) have helped.

I am as “comfortable in my own skin” as I know how to be, take responsibility for my health where I can, and continue to work full-time now that I’m past my initial recuperative period. I provide for my family and provide emotional, intellectual, loving support for my family. I ride my motorcycle regularly. My youngest daughter and I rode our bicycles in a 20-mile fund-raising event for the American Diabetes Association. I’m training for my first 5K running event in support of funding for PrCa research. I try to be supportive to others through this forum and our local chapter of Us Too. I meditate daily and do yoga on non-running days. I share the housework and read to my vision-impaired wife. She and I do enjoy intimacy and I’ve tried to be a sensitive and giving lover within my current capabilities. But our loss still hurts. It hurts her and that hurts me. And, deep down, there are the fears voiced by Henry (Explanatory note here -- Henry voiced fears on Facebook that his wife would leave him for a more capable lover) —and I do not mean to slight my wife nor disrespect her in any way when I voice this. I believe that if you have not suffered the loss of something that, for your adult life, has been part of your being and part of what you could offer in a loving relationship you probably don’t really understand. And for that, you must be forgiven.

So, Patsy, what is a real man?  And how can anyone define that for any other person?

I await her reply.